Cognitive impairment in hoarding disorder: a systematic review.

OBJECTIVE: In the present study, we aimed to perform a systematic review evaluating the cognitive performance of patients with hoarding disorder (HD) compared with controls. We hypothesized that HD patients would present greater cognitive impairment than controls. METHODS: A systematic search of the literature using the electronic databases MEDLINE, SCOPUS, and LILACS was conducted on May 2020, with no date limit. The search terms were "hoarding disorder," "cognition," "neuropsychology," "cognitive impairment," and "cognitive deficit." We included original studies assessing cognitive functioning in patients with HD. RESULTS: We retrieved 197 studies initially. Of those, 22 studies were included in the present study. We evaluated 1757 patients who were 41 to 72 years old. All selected studies comprised case-control studies and presented fair quality. Contrary to our hypothesis, HD patients showed impairment only in categorization skills in comparison with controls, particularly at confidence to complete categorization tasks. Regarding attention, episodic memory, working memory, information-processing speed, planning, decision-making, inhibitory control, mental flexibility, language, and visuospatial ability, HD patients did not show impairment when compared with controls. There is a paucity of studies on social cognition in HD patients, although they may show deficits. The impact of emotion in cognition is also understudied in HD patients. CONCLUSION: Except for categorization skills, the cognitive performance in HD patients does not seem to be impaired when compared with that in controls. Further work is needed to explore social cognition and the impact of emotion in cognitive performance in HD patients.

Cognitive performance of individuals with animal hoarding.

BACKGROUND: The purpose of this study was to characterize the cognitive performance of individuals with animal hoarding. METHODS: This is a cross-sectional study, in which 33 individuals between the ages of 29 to 84 (M = 61.39; SD = 12.69) with animal hoarding have been assessed. The participants completed a neurocognitive battery including measures of general cognitive functioning, visual memory and organization, verbal fluency, and verbal reasoning. RESULTS: Data suggest that individuals with animal hoarding have high rates of cognitive deficits related to visual memory and verbal reasoning. CONCLUSIONS: Based on the performance tests used, we can suggest the existence of cognitive difficulties related especially to the executive functions of individuals with animal hoarding in this sample.

Animal Hoarding Disorder: A new psychopathology?

This study aimed to characterize the sociodemographic profile of animal hoarders in a southern city of Brazil. In addition, it aimed to propose Animal Hoarding Disorder as a new nosological category, distinct from Hoarding Disorder. Thirty-three individuals with Animal Hoarding Disorder, 73% female and 60% elderly, composed the sample. The average age of the sample was 61.39 years (SD = 12.69) and the average period that individuals hoarded or lived with a large number of animals was 23.09 years (SD = 15.98.) It was observed that 56.7% of the sample hoarded other inanimate objects, besides the animals. The total number of hoarded animals was 1.357 and the average number of animals per hoarder was approximately 41 (SD = 24.41). Significant differences between hoarding disorder and animal hoarding are discussed. Unlike hoarded objects, hoarded animals generally do not obstruct domicile environments. The processes of disengaging from or donating animals also differ from those of object hoarding, since there is an affectional bond with lives and not with unanimated objects. In this sense, the characterization of Animal Hoarding Disorder as a new mental disorder may arouse great interest from both clinical professionals and researchers.

Avaliação de sintomas psicológicos no transtorno da acumulação: um estudo de caso / Psychological symptom evaluation in accumulation disorder: a case study / Evaluación de síntomas psicológicos en trastorno de acumulación: estudio de un caso

O Transtorno da Acumulação (TA) caracteriza-se pela aquisição de itens desnecessários, dificuldade em se desfazer de objetos e a desorganização do ambiente de convívio. O estudo de caso analisa as características de personalidade e os sintomas psicológicos comórbidos em uma paciente com diagnóstico de TA. Para o levantamento de dados, utilizou-se uma entrevista semiestruturada, o Questionário dos Esquemas de Young (QEY-S2), o Inventário dos Estilos Parentais de Young (IEP), o Inventário de Depressão e Ansiedade de Beck (BDI-II e BAI, respectivamente), o Inventário de Sintomas de Stress de Lipp (ISSL) e o Método de Rorschach. Nos resultados, observou-se a presença de Esquemas Iniciais Desadaptativos (EIDs) pertencentes ao domínio de desconexão e rejeição, sugerindo uma conexão entre os sintomas do TA e experiências emocionais negativas vivenciadas pela paciente durante a infância. Futuramente, recomenda-se a realização de novos estudos com delineamento transversal no intuito de substanciar os resultados obtidos pela presente pesquisa. (AU)

Accumulation disorder (AD) is characterized by the acquisition of unnecessary items, difficulty in disposing objects, and disorganization of the convivial environment. The case study analyzes personality characteristics and comorbid psychological symptoms in a patient diagnosed with AD. For data collection, a semi-structured interview was used, the Young Schema Questionnaire (YSQ-S2), the Young Parenting Styles Inventory (PSI), the Beck Depression Inventory and the Beck Anxiety Inventory (BDI-II and BAI, respectively), the Lipp Stress Symptoms Inventory (LSSI), and the Rorschach Method. In the results, we observed the presence of Early Maladaptive Schemas (EMS) belonging to the disconnection and rejection domain, suggesting a connection between AD symptoms and negative emotional experiences experienced by the patient during childhood. In the future, new studies with a cross-sectional design are recommended in order to substantiate the results obtained by the present research. (AU)

El trastorno de acumulación (TA) se caracteriza por adquisición de artículos desnecesarios, dificultad de deshacerse de objetos y desorganización en el ambiente de convivencia. El estudio de caso analiza las características de personalidad y los síntomas psicológicos comórbidos en un paciente con diagnóstico de TA. Para el levantamiento de datos se ha utilizado una entrevista semiestructurada, el cuestionario de los Esquemas de Young (QEY-S2), el Inventario de los Estilos Parentales de Young (IEP), el Inventario de Depresión y Ansiedad de Beck (BDI-II e BAI, respectivamente) el Inventario de Síntomas de Stress de Lipp (ISSL) y el Método de Rorschach. En los resultados, se ha observado presencia de Esquemas iniciales desadaptativos (EIDs) pertenecientes al dominio de desconexión y rechazo, sugiriendo una conexión entre los síntomas del TA y experiencias emocionales negativas vividas por el paciente durante la infancia. Futuramente, se recomienda la realización de nuevos estudios con delineamiento transversal con el fin de sustanciar los resultados obtenidos por esta investigación. (AU)

Acumuladores de animais

Desde os primórdios da humanidade o homem interage com os animais,o que resulta em uma relação benéfica para as espécies. No entanto, a superpopulação de cães e gatos tem se tornado um problema grave de saúde pública e de bem-estar animal. A guarda responsável é indispensável para a garantia das condições de saúde dos animais e da população em geral, além de reduzir os riscos de transmissão de zoonoses e a ocorrência de outros agravos (Instituto Pasteur, 2000).

Acumuladores de animais

Desde os primórdios da humanidade o homem interage com os animais,o que resulta em uma relação benéfica para as espécies. No entanto, a superpopulação de cães e gatos tem se tornado um problema grave de saúde pública e de bem-estar animal. A guarda responsável é indispensável para a garantia das condições de saúde dos animais e da população em geral, além de reduzir os riscos de transmissão de zoonoses e a ocorrência de outros agravos (Instituto Pasteur, 2000).

The correlates of obsessive-compulsive, schizotypal, and borderline personality disorders in obsessive-compulsive disorder.

We assessed correlates of obsessive-compulsive (OCPD), schizotypal (SPD) and borderline (BPD) personality disorders in 110 obsessive-compulsive disorder (OCD) patients. We found OCD patients with OCPD (20.9%) to exhibit higher rates of hoarding and bipolar disorders, increased severity of hoarding and symmetry, lower prevalence of unacceptable thoughts involving sex and religion and less non-planning impulsivity. Conversely, OCD patients with SPD (13.6%) displayed more frequently bipolar disorder, increased severity of depression and OCD neutralization, greater prevalence of "low-order" behaviors (i.e., touching), lower low-planning impulsivity and greater "behavioral" compulsivity. Finally, in exploratory analyses, OCD patients with BPD (21.8%) exhibited lower education, higher rates of several comorbid psychiatric disorders, greater frequency of compulsions involving interpersonal domains (e.g. reassurance seeking), increased severity of depression, anxiety and OCD dimensions other than symmetry and hoarding, more motor and non-planning impulsivity, and greater "cognitive" compulsivity. These findings highlight the importance of assessing personality disorders in OCD samples.

Neither bipolar nor obsessive-compulsive disorder: compulsive buyers are impulsive acquirers.

INTRODUCTION: Compulsive buying (CB) is currently classified as an impulse control disorder (ICD) not otherwise classified. Compulsive buying prevalence is estimated at around 5% of the general population. There is controversy about whether CB should be classified as an ICD, a subsyndromal bipolar disorder (BD), or an obsessive-compulsive disorder (OCD) akin to a hoarding syndrome. To further investigate the appropriate classification of CB, we compared patients with CB, BD, and OCD for impulsivity, affective instability, hoarding, and other OCD symptoms. METHOD: Eighty outpatients (24 CB, 21 BD, and 35 OCD) who were neither manic nor hypomanic were asked to fill out self-report questionnaires. RESULTS: Compulsive buying patients scored significantly higher on all impulsivity measures and on acquisition but not on the hoarding subdimensions of clutter and "difficulty discarding." Patients with BD scored higher on the mania dimension from the Structured Clinical Interview for Mood Spectrum scale. Patients with OCD scored higher on obsessive-compulsive symptoms and, particularly, higher on the contamination/washing and checking dimensions from the Padua Inventory; however, they did not score higher on any hoarding dimension. A discriminant model built with these variables correctly classified patients with CB (79%), BD (71%), and OCD (77%). CONCLUSION: Patients with CB came out as impulsive acquirers, resembling ICD- rather than BD- or OCD-related disorders. Manic symptoms were distinctive of patients with BD. Hoarding symptoms other than acquisition were not particularly associated with any diagnostic group.

Psychiatry disorders and dengue: Is there a relationship? / Transtornos psiquiátricos e dengue: existe uma correlação?

OBJECTIVE: The aim of this study was to examine the relationship of compulsive hoarding with dengue. METHOD: Fifty two adults notified by health vigilance authorities because of inappropriate trash accumulation in vacant lots in Goiânia, Central Brazil, completed a questionnaire regarding the presence and severity of hoarding behavior (Hoarding Rating Scale-Interview HRS-I). Five dimensions of hoarding are evaluated with this instrument: difficulty using spaces due to clutter, difficulty discarding possessions, excessive acquisition of objects, emotional distress and functional impairment due to hoarding behaviors. RESULTS: The sample was primarily male, with an average age of 49 years. Eighty six percent of the sample scored 14 or greater on the HRS-I, indicating pathological hoarding. The medias of the five HRS-I domains were high, indicating severeness of all dimentions of pathological hoarding. CONCLUSION: These results highlight the relationship between psychiatric disorder and actions upon environmental conditions that favors dengue, as well as its associated public health burden.

OBJETIVO: O objetivo deste estudo foi examinar a relação entre colecionismo compulsivo e a dengue. MÉTODO: Cinquenta e dois adultos notificados pelas autoridades de vigilância sanitária por causa do acúmulo inadequado de lixo em lotes vagos em Goiânia, no Brasil Central, completaram um questionário sobre a presença e gravidade de comportamentos de colecionismo (Hoarding Rating Scale - Interview - HRS-I). Cinco dimensões de colecionismo são avaliadas com esse instrumento: a dificuldade de utilização do espaço devido à intensa desorganização, dificuldade de descartar pertences sem função, aquisição excessiva de objetos, distúrbios emocionais e comprometimento funcional devido a comportamentos de colecionismo. RESULTADOS: A amostra foi predominantemente do sexo masculino, com idade média de 49 anos. Oitenta e seis por cento da amostra atingiu 14 pontos ou mais na HRS-I, indicando colecionismo patológico. As médias dos cinco domínios do HRS-I foram altas, indicando gravidade de todas as dimensões de colecionismo patológico. CONCLUSÃO: Estes resultados ressaltam a relação entre transtorno psiquiátrico e as ações sobre as condições ambientais que favorecem a disseminação da dengue, bem como o problema de saúde pública associado.

Dimensional correlates of poor insight in obsessive-compulsive disorder.

BACKGROUND: Cross-sectional studies have associated poor insight in patients with obsessive-compulsive disorder (OCD) with increased OCD symptom severity, earlier age of onset, comorbid depression, and treatment response. The goal of this current study was to examine the relationship between dimensions of OCD symptomatology and insight in a large clinical cohort of Brazilian patients with OCD. We hypothesized that poor insight would be associated with total symptom severity as well as with hoarding symptoms severity, specifically. METHODS: 824 outpatients underwent a detailed clinical assessment for OCD, including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS), the Brown Assessment of Beliefs Scale (BABS), a socio-demographic questionnaire, and the Structured Clinical Interview for axis I DSM-IV disorders (SCID-P). Tobit regression models were used to examine the association between level of insight and clinical variables of interest. RESULTS: Increased severity of current and worst-ever hoarding symptoms and higher rate of unemployment were associated with poor insight in OCD after controlling for current OCD severity, age and gender. Poor insight was also correlated with increased severity of current OCD symptoms. CONCLUSION: Hoarding and overall OCD severity were significantly but weakly associated with level of insight in OCD patients. Further studies should examine insight as a moderator and mediator of treatment response in OCD in both behavioral therapy and pharmacological trials. Behavioral techniques aimed at enhancing insight may be potentially beneficial in OCD, especially among patients with hoarding.